Antibiotics with an attitude: are they working?
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Biomedical subjects
Publications and source records attributed to B Berlin.
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While ethnobotany has emerged as an important discipline in the search for new drugs, this economic impetus should in no way distract from a more ethnobiological and equally critical goal--the codification and promotion of indigenous medical systems as a major factor in the conservation of biocultural diversity. Codification of indigenous medical systems requires a holistic view which entails (1) in-depth understanding of the recognized health conditions in the native system and how they might be described in terms of Western biomedicine; (2) comprehensive inventories of medicinal species employed in the native system, descriptions of their modes of preparation and administration and giving priority to those species most likely to merit pharmacological testing; and (3) identification of the pharmacological properties of these species with the goal of discovering how they might be effective in the treatment of the health conditions for which they are employed. Promotion of indigenous medical systems requires the development of local training programmes aimed at the active conservation and enhancement of traditional herbal medicinal therapies that have been shown to be pharmacologically effective in the treatment of symptoms of recognized health conditions. The establishment of such programmes is critical at a time when traditional medical systems are often disparaged as worthless by the national societies in which indigenous peoples live, as well as by younger members of the native populations themselves.
In 1990, 3049 Boston public middle and high school students were surveyed anonymously in English, Spanish, Vietnamese, Chinese, French, or Haitian Creole. Significantly fewer immigrant students, 35% of those surveyed, knew the principal modes of human immunodeficiency virus transmission. Fewer immigrants reported having sexual intercourse (31% vs 53% of nonimmigrants), but among the sexually active only 38% always used condoms, and more immigrants reported intercourse with intravenous drug users (4% vs 1% of non-immigrants). AIDS education should be taught to immigrant students in their native languages.
Despite substantial progress, adolescents remain at high risk for human immunodeficiency virus (HIV) infection. Two independent random digit dial statewide Massachusetts surveys of 16- to 19-year-old persons conducted August through September 1986 and 1988 revealed that the proportion of teenagers who had discussed acquired immunodeficiency syndrome (AIDS) in schools increased from 52% to 82%. Knowledge about how AIDS is transmitted was also significantly higher in 1988. The proportion of teenagers using drugs other than alcohol and marijuana declined from 13% to 9%, and intravenous drug use declined from 1% to 0.1%. At the same time, among sexually active teenagers, the proportion who reported changes in sexual behavior to avoid AIDS increased from 16% to 34%. The proportion who adopted condom use to avoid AIDS increased from 2% to 19%. However, the overall proportion of teenagers who reported sexual intercourse in the past year increased significantly from 55% to 61%. In 1988, among sexually active teenagers, 37% never used condoms and 33% used them only some of the time. Of all respondents, 18% reported unprotected sex with more than one partner in the previous year, and 3% reported unprotected sex with intravenous drug users. Although mass media and school education may increase knowledge and stimulate some teenagers to change behavior, for others more personal forms of counseling may be needed. The effects of increasing physician counseling warrant special study. Teenagers who had spoken to physicians about AIDS were much more likely to have adopted condom use to avoid HIV exposure. However, although 80% of adolescents saw a physician in the past year, only 13% were counseled about AIDS.
In October 1987, 1,323 Massachusetts residents were randomly interviewed by telephone to explore their exposure to AIDS educational efforts, levels of knowledge about AIDS, and whether that knowledge modified their behavior. Gay/bisexual males, iv drug users and heterosexual respondents were compared as were blacks, Hispanics, and whites. While 81% of respondents had read or heard mass media stories about AIDS, in the previous week, only 5% had ever been counseled about AIDS by a physician. Over 97% of black (N = 152) and white respondents (N = 1,057), as well as gay/bisexual males (N = 21) and iv drug users (N = 33) were aware that HIV can be transmitted by homosexual or heterosexual intercourse and by sharing needles when injecting drugs. However, 9% of the 55 Hispanics interviewed were unaware of male homosexual transmission, and 7% did not know about heterosexual transmission or the risks of needle sharing. Twenty percent of Hispanics, compared with 9% of other respondents, did not know HIV can be transmitted sexually by someone who appears healthy. Fifty-two percent of gay/bisexual males, 27% of iv drug users, and 21% of those who had multiple heterosexual partners in recent years reported adopting abstinence, monogamous relations, or condom use to avoid HIV exposure. Those who continued risky behavior were just as knowledgeable about HIV transmission, but they were less likely to report that they worry a great deal about getting AIDS, 14% vs 32%. The results indicate that new strategies and resources are needed to educate Hispanics. Physicians need to counsel more persons about HIV transmission and further efforts are needed to translate knowledge about HIV transmission into behavior change to avoid the virus.
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Twenty-one healthy, middle-aged volunteers and 8 patients with chronic lung disease were given live, attenuated influenza virus vaccine by nasal spray. Forced vital capacity, 1-sec forced expiratory volume, ratio of 1-sec forced expiratory volume to forced vital capacity, residual volume, ratio of airway conductance to lung volume, maximal expiratory flows after exhalation of 50 and of 75 per cent of the forced vital capacity, closing volume, slope of Phase III, volume of isoflow, single-breath diffusing capacity for CO, and arterial blood gases were measured before and 3, 7, 10, and 21 days after exposure. Vaccination was well tolerated by the healthy volunteers without change in pulmonary function. In contrast, the patients tended to develop increased respiratory symptoms and had a slight decrease in mean forced expiratory volume in 1 sec 3 weeks after vaccination.
By the use of five independent techniques, cell surface alterations distinctive of malignant as compared to normal colon cells were detected on in vivo surgical specimens and on cultured cell lines established in our laboratory. The findings, which were distinctive of the malignant as compared to the normal cell included: (a) polymorphism of surface microvilli on scan electron microscopy; (b) decreased susceptibility to infection with vaccinia and reovirus, but not to herpes, adeno- or echovirus: (c) production of large quantities of carcinoembryonic antigen; (d) presence of specific membrane proteins on sodium dodecyl sulfate-polyacrylamide gel analysis of plasma membranes purified from cell homogenates by ultracentrifugation in polyethylene glycol-dextran partitions; and (e) reaction with specific, cytotoxic, rabbit heteroantisera. Solubilized extracts of the malignant cells formed precipitin lines with the heteroantisera, suggesting that the distinctive antigens could be released from the cell surface. These results suggest that human colon carcinomas bear tumor-distinctive proteins and offer the prospect of specific immunodiagnostic reagents and immunotherapeutic tools.
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